LETICIA LESSA MANSUR
Projetos de Pesquisa
Unidades Organizacionais
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
13 resultados
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Agora exibindo 1 - 10 de 13
- Inference comprehension from reading in individuals with mild cognitive impairment(2021) SILAGI, Marcela Lima; ROMERO, Vivian Urbanejo; OLIVEIRA, Maira Okada de; TRES, Eduardo Sturzeneker; BRUCKI, Sonia Maria Dozzi; RADANOVIC, Marcia; MANSUR, Leticia LessaInference comprehension is a complex ability that recruits distinct cognitive domains, such as language, memory, attention, and executive functions. Therefore, it might be sensitive to identify early deficits in subjects with MCI. To compare the performance of subjects with mild cognitive impairment (MCI) in an inference reading comprehension task, and to analyze the correlations between inferential comprehension and other cognitive functions. We studied 100 individuals aged 60 and over, divided into MCI (50) [aMCI (35), naMCI (15)], and cognitively healthy individuals [controls (50)]. The Implicit Management Test (IMT) was used to assess inference in reading comprehension in five categories: explicit, logical, distractor, pragmatic, and ""others"". MCI group performed worse than controls in logical, pragmatic, distractor, and ""others"" questions (p < 0.01). The aMCI and naMCI subgroups presented a similar performance in all types of questions (p > 0.05). We observed significant correlations between the total IMT score and the TMT-A in the naMCI group (r = - 0.562, p = 0.036), and the Rey-Osterrieth Complex Figure and RAVLT tasks in the aMCI group (r = 0.474, p = 0.010 and r = 0.593, p = 0.0001, respectively). The MCI group as a whole performed worse than controls on the logical, pragmatic, other and distractor questions, and consequently on the total score. There were no differences in explicit questions, which impose lower inferential demands. The aMCI group suffered a significant impact from memory on inference comprehension, and difficulties in executive functions impacted naMCI performance. The IMT was useful to differentiate MCI patients from cognitively healthy individuals, but not MCI subgroups among themselves.
- Language impairment in Huntington's disease(2012) AZAMBUJA, Mariana Jardim; RADANOVIC, Marcia; HADDAD, Monica Santoro; ADDA, Carla Cristina; BARBOSA, Egberto Reis; MANSUR, Leticia LessaLanguage alterations in Huntington's disease (HD) are reported, but their nature and correlation with other cognitive impairments are still under investigation. This study aimed to characterize the language disturbances in HD and to correlate them to motor and cognitive aspects of the disease. We studied 23 HD patients and 23 controls, matched for age and schooling, using the Boston Diagnostic Aphasia Examination, Boston Naming Test, the Token Test, Animal fluency, Action fluency, FAS-COWA, the Symbol Digit Modalities Test, the Stroop Test and the Hooper Visual Organization Test (HVOT). HD patients performed poorer in verbal fluency (p<0.0001), oral comprehension (p<0.0001), repetition (p<0.0001), oral agility (p<0.0001), reading comprehension (p=0.034) and narrative writing (p<0.0001). There was a moderate correlation between the Expressive Component and Language Competency Indexes and the HVOT (r=0.519, p=0.011 and r=0.450, p=0.031, respectively). Language alterations in HD seem to reflect a derangement in both frontostriatal and frontotemporal regions.
- Language alterations in subcortical lesions: New concepts(2011) RADANOVIC, M.; MANSUR, L. L.The role of subcortical structures in language processing is a topic of intense debate in the literature. Language alterations resulting from subcortical damage, such as the basal ganglia and thalamus do not produce classical aphasia syndromes as those encountered in cortical lesions. Basal ganglia lesions (caudate nucleus, putamen, globus pallidus) produce a complex and varied symptomatology regarding language manifestations, being the more consistent an alteration in lexical selection processes. More recent theories implicate the striatum in sequential and computational aspects of language processing, combinatorial rule applications and procedural learning (which are related to morphology and syntax), as well as stuttering. Thalamic aphasias present a more homogeneous pattern, where anomia and semantic paraphasias predominate, pointing to the role of the thalamus in mechanisms of cortical engagement and semantic verification. There has been increasing evidence of the participation of the cerebellum in language processing. Among the language deficits found after cerebellar lesions are delay in language acquisition, deficits in speech initiation, and mutism. Other previously reported language alterations include deficits in speech production, such as short responses, difficulties in initiating a conversation, long latencies for answers, and word finding difficulties. © 2011 Bentham Science Publishers. All rights reserved.
- Aphasia in vascular lesions of the basal ganglia: A comprehensive review(2017) RADANOVIC, Marcia; MANSUR, Leticia LessaBetween 1970 and 1990, the study of aphasia secondary to subcortical lesions (including the basal ganglia - BG) was largely driven by the advent of modern neuroimaging techniques such as MRI and PET. However, attempts to characterize a pattern of language abnormalities in patients with basal ganglia lesions proved unfruitful. We conducted a comprehensive review of language disturbances after vascular lesions in the BC. Literature search in Medline and LILACS (1966-2016) and PsychINFO (last 25 years) was conducted, and returned 145 articles, with 57 eligible for the review yielding data on 303 patients. We report the clinical and neuroimaging features of these cases. Results showed that aphasias caused by BG lesions are heterogeneous with weak clinicoanatomical correlations. Data derived from follow-up and flow/metabolism studies suggest that subcortical aphasia caused by BG lesions involves hypoperfusion in the cortical territories of the middle cerebral/internal carotid arteries (MCA/ICA) and their branches.
- Comparison of language impairment in late-onset depression and Alzheimer's disease(2011) NOVARETTI, Tania M. da Silva; FREITAS, Maria I. D'Avila; MANSUR, Leticia L.; NITRINI, Ricardo; RADANOVIC, MarciaObjectives: Depression and dementia are highly prevalent in the elderly. Language impairment is an inherent component of Alzheimer's disease (AD), which can also be encountered in depressed patients. The aim of this study wasto compare the profiles of language abilities in late-onset depression and mild AD groups. Methods: We studied 25 patients with late-onset depression (mean age 73.6 +/- 6.6 years; schooling 9.1 +/- 5.7 years) and 30 patients with mild AD (77.6 +/- 5.4 years; 7.5 +/- 7.1 years) using the Arizona Battery for Communication Disorders of Dementia (ABCD), compared to a group of 30 controls (73.8 +/- 5.8 years; 9.1 +/- 5.4 years). Cut-off scores to discriminate between Controls x Depression and Depression x AD were determined. Results: Depressed patients' scores were similar to AD in confrontation naming, concept definition, following commands, repetition and reading comprehension (sentence). Episodic memory and mental status subtests were useful in differentiating depressed patients from AD, a result that was reproduced when using analysis of covariance to control for the effect of age in the same subtests (p = 0.01 and 0.04, respectively). Conclusion: Language impairment resembling AD was found in the aforementioned language subtests of the ABCD in elderly depressed patients; the mental status and episodic memory subtests were useful to discriminate between AD and depression. The ABCD has proven to be a suitable tool for language evaluation in this population and should aid in the differentiation of AD and pseudodementia (as that of depression).
- Normal language: Cognitive and linguistic models(2011) RADANOVIC, M.; MANSUR, L. L.Language is the ""most human"" of all cognitive abilities. Hence, understanding how our brains process language has intrigued neuroscientists since the first description of an aphasic patient by Paul Broca at the end of the eighteenth century. Much of our knowledge about language processing derives from the observation of signs and symptoms caused by brain injury, but normal language is also a topic of investigation among researchers, from Psycholinguistics to Computational Sciences. However, the exact nature of linguistic processing is yet to be fully understood. Oral language comprehension seems to be based on the auditory discrimination of word subunits, which vary depending on the language considered: stress units (English), syllables (French), mora (Japanese), and so on. These subunits must then be grouped and a selection mechanism has to discriminate among similar words to avoid ambiguities. Grammatical rules contribute to organize words (in their morphosyntactic aspects), and, finally, context and prosody give their contribution so that the listener is able to understand the content of discourse, as in a conversation. Language production relies on the phylogenetic development of a specific supra-laryngeal articulation mechanism under neocortical control, and also of a social competence now described as Theory of Mind (ToM). Language production starts with the mental generation of a message to be conveyed; this message has to be translated into grammatically encoded words. Grammatical encoding includes lemma selection, morphosyntactic composition, morphophonological and phonetic encoding, in a complex process at the end of which the message (words) is uttered by the speaker. © 2011 Bentham Science Publishers. All rights reserved.
- Inference comprehension during reading: influence of age and education in normal adults(2014) SILAGI, Marcela Lima; ROMERO, Vivian Urbanejo; MANSUR, Leticia Lessa; RADANOVIC, MarciaPurpose: To determine the effect of age and education on inferential comprehension from written texts in normal individuals. Methods: A total of 224 normal adults were stratified into nine groups according to age (young: 18–39 years, adults: 40–59 years, and elderly: 60–79 years) and educational level (low ≤4 years, medium: 5–8 years and high >8 years) and were evaluated through the battery La gestion de l'implicite (Implicit Information Management Test) to determine the ability to make inferences through different types of questions: explicit, logical, distractor, pragmatic and others. Results: The elderly showed worse performance for total score and distractor questions. Regarding educational level, all groups differed on explicit, logical, distractor questions, and on total test score. Subjects with high schooling performed better on pragmatic inferences and others. Conclusion: Age influence on the comprehension of inferences may be due to difficulties in attention and executive functions. The strong effect of education can be explained by the interaction of inferential abilities with other cognitive functions such as working memory, vocabulary span, as well as world knowledge.
- Linguistic abilities in major vascular cognitive impairment: a comparative study with Alzheimer's disease(2018) FREITAS, Maria Isabel D'Avila; PORTO, Claudia S.; OLIVEIRA, Maira O.; BRUCKI, Sonia M. D.; MANSUR, Leticia L.; NITRINI, Ricardo; RADANOVIC, MarciaWe assessed the linguistic abilities of multi-infarct (cortical) dementia and subcortical ischemic vascular dementia (VaD) patients and compared the linguistic performance of VaD and Alzheimer's Disease (AD) patients. A total of 23 VaD patients, 20 mild AD patients, and 31 controls participated in the study. All were evaluated using the Arizona Battery for Communication Disorders of Dementia (ABCD). Neuropsychological testing was performed to ascertain that VaD and AD patients had comparable cognitive performance. Both dementia groups performed more poorly than controls in the ABCD measures, except for the comparative question subtest. Comparison between VaD and AD patients showed statistically significant differences only in the confrontation naming subtest (p < 0.05), where paraphasias and visual errors were the most prevalent. AD patients showed a trend towards more circumlocution errors than VaD patients (p = 0.0483). When compared to controls, linguistic abilities of VaD patients were impaired in all measures of linguistic expression and linguistic comprehension, except for the comparative question subtest. Linguistic differences between VaD and AD patients were observed only in the confrontation naming subtest.
- Applicability of the ""An Object and Action Naming Battery"" in Brazilian Portuguese(2013) SPEZZANO, Luisa Carmen; MANSUR, Leticia Lessa; RADANOVIC, MarciaPURPOSE: To verify the performance of a sample of Brazilian subjects in the ""An Object and Action Naming Battery"" (OANB), according to schooling; and to describe the main error types in nouns and verbs naming. METHODS: The OANB was applied in 100 healthy subjects, divided in two groups (GI: four to eight years of schooling; and GII: above nine years). RESULTS: There were correct answers for 97.6% for nouns and 98.0% for verbs. There were statistically significant differences between the groups in the number of correct answers for nouns and verbs (p<0.0001) and in the proportion of semantic errors for verbs (p=0.0160), with less educated subjects performing poorer than higher educated ones. CONCLUSION: The OANB may be used in adult Brazilian Portuguese native speakers. The group with higher education had higher scores; both groups had a higher proportion of ""semantic errors"" for verbs and nouns.
- Language alterations in focal lesions: Current concepts in aphasia(2011) RADANOVIC, M.; MANSUR, L. L.Aphasia can be defined as an acquired deficit in language processing due to dysfunction in specific areas of the brain. The classic aphasias (Broca's, Wernicke's and Global) are representative of impairment in the very epicenters of language areas, thus inducing signs and symptoms that affect all levels of linguistic processing: phonological, syntactical, lexical, and semantic. However, there is a group of aphasias in which the lesion site spares the classic language areas, thus inducing more subtle signs and symptoms, and leading to a combination of linguistic symptoms mixed with those arising from other cognitive functions also affected by the same lesion. That is the case with the so called ""transcortical aphasias"" and ""conduction aphasia"". Transcortical aphasias are classified as motor, sensory, and mixed. In transcortical motor aphasia (TCMA), the medial and the dorsolateral frontal lobes are compromised, interrupting the connections between these two systems and language areas; TCMA patients have impairment performance on tasks demanding speech generation (diminished fluency, impairment in narrative, and in the production of grammatically complex sentences), and a reduction in the motivation to engage in communication. In transcortical sensory aphasia (TCSA) there is a disorder in semantic processing, manifesting as comprehension and naming impairment, which indicates a disconnection between posterior language areas and semantic memory. In mixed transcortical aphasia (MTA) there is a combination of signs and symptoms of both TCMA and TCSA in varying degrees. Conduction aphasia, in which the core symptom is repetition deficit, represents a primary failure of the phonological loop. © 2011 Bentham Science Publishers. All rights reserved.